Microsatellite instability (MSI) is a tumor phenotype whose diagnosis largely impacts patient care in colorectal cancers (CRC), and is associated with response to immunotherapy in all solid tumors. Deep learning models detecting MSI tumors directly from H&E stained slides have shown promise in improving diagnosis of MSI patients. Prior deep learning models for MSI detection have relied on neural networks pretrained on ImageNet dataset, which does not contain any medical image. In this study, we leverage recent advances in self-supervised learning by training neural networks on histology images from the TCGA dataset using MoCo V2. We show that these networks consistently outperform their counterparts pretrained using ImageNet and obtain state-of-the-art results for MSI detection with AUCs of 0.92 and 0.83 for CRC and gastric tumors, respectively. These models generalize well on an external CRC cohort (0.97 AUC on PAIP) and improve transfer from one organ to another. Finally we show that predictive image regions exhibit meaningful histological patterns, and that the use of MoCo features highlighted more relevant patterns according to an expert pathologist.
Building machine learning models from decentralized datasets located in different centers with federated learning (FL) is a promising approach to circumvent local data scarcity while preserving privacy. However, the prominent Cox proportional hazards (PH) model, used for survival analysis, does not fit the FL framework, as its loss function is non-separable with respect to the samples. The na\"ive method to bypass this non-separability consists in calculating the losses per center, and minimizing their sum as an approximation of the true loss. We show that the resulting model may suffer from important performance loss in some adverse settings. Instead, we leverage the discrete-time extension of the Cox PH model to formulate survival analysis as a classification problem with a separable loss function. Using this approach, we train survival models using standard FL techniques on synthetic data, as well as real-world datasets from The Cancer Genome Atlas (TCGA), showing similar performance to a Cox PH model trained on aggregated data. Compared to previous works, the proposed method is more communication-efficient, more generic, and more amenable to using privacy-preserving techniques.